Bill to legalize supported adult use receives bipartisan support.
Bill to legalize supported adult use receives bipartisan support.
January 9, 2023
*Originally published on Psychedelic Week.
This year, State Senator Jesse Salomon is sponsoring an updated version of Washington’s Psilocybin Services Wellness and Opportunity Act (Senate Bill 5263). A previous draft of the bill, SB 5660, was introduced during Washington’s 2022 legislative session.
This article provides a detailed preview of the updated bill. Like its predecessor, the 2023 version regulates supported adult use, which allows clients to access psilocybin without a medical diagnosis or prescription. It contains significant updates. Many are original. Others were gleaned from observing Oregon’s implementation of Measure 109 and Colorado’s approval of Proposition 122, while learning from their successes and potential missteps.
Extended Implementation Period
SB 5263 extends the previous version’s 18-month implementation period to 24 months. That’s six months longer than the Natural Medicine Health Act’s rulemaking phase but comparable in length to the rulemaking period for Oregon’s Measure 109.
Enhanced Protections for Employees and Professionals
In addition to shielding employees from being fired for utilizing psilocybin services, the updated bill protects healthcare providers from being disciplined or sanctioned for recommending psilocybin services or assisting clients in obtaining them.
Mandatory Group Administration Rules
SB 5263 requires Washington’s Department of Health to make rules for group administration sessions. Similarly, the Natural Medicine Health Act requires Colorado’s governing agency, the Department of Regulatory Agencies (DORA), to allow communal consumption. By comparison, Oregon’s Measure 109 gave the Oregon Health Authority discretion to prohibit group administration. However, in response to advisory board recommendations, and significant public input, the Health Authority created extensive rules for group settings. Codifying a requirement for group administration is a significant improvement because group sessions could make psilocybin services more affordable. In addition to reflecting how psychedelics are traditionally consumed, group sessions may have other benefits such as promoting a sense of community, reducing anxiety, and improving outcomes.
Flexible Administration Sites
Two limitations of Measure 109 are its rigid linkage of service centers to fixed facilities and a related prohibition on home administration sessions. Many people who may benefit from psychedelic services cannot travel to licensed service centers. More recent legislation like Colorado’s Natural Medicine Health Act has addressed this problem by defining service centers as entities rather than specific facilities, allowing administration sessions to occur in a wider variety of locations.
Like Colorado’s law, Washington’s SB 5263 allows psilocybin administration to occur outside a service center (at other locations permitted by the Department of Health). Though both Colorado’s law and SB 5263 leave these locations to be determined by state agencies, SB 5263 provides additional guidance. For instance, locations that the Department of Health may permit must include veterans’ organizations, houses of worship, private residences, outdoor spaces, and other locations to be determined by the agency. Neither Colorado’s law nor SB 5263 allows for consumption in public spaces, and SB 5263 adds an additional prohibition on holding administration sessions in vehicles such as RVs.
Expanded Facilitator Training Requirements and License Types
Regarding training for psilocybin facilitators, SB 5263 increases the hours of required hands-on training from 40 hours, the number required in Oregon, to 250 hours. Moreover, SB 5263 creates a new license type for facilitator trainees. Once candidates have completed the core training curriculum, which consists of 120 hours of classroom-type instruction (the same as Oregon), they can apply for a facilitator trainee license. This license qualifies them to complete 250 hours of clinical experience under a qualified supervisor, who must have two-years’ experience or meet other requirements defined by the Department of Health. At least 48 of the 250 practicum hours must include direct co-facilitation with the supervisor.
No Dosage Limit Below Five Grams
SB 5263 prohibits the Department of Health from implementing a maximum dose lower than 5 grams of dried psilocybe cubensis mushrooms. By comparison, the Oregon Health Authority implemented a dose limit 50 mg of isolated psilocybin. The Oregon agency declined to provide dosage guidelines in grams of whole fungi, leaving many stakeholders confused. It remains somewhat unclear how Oregon service centers will handle the administration of whole fungi.
No Local Opt-Out Provisions
Oregon’s Measure 109 allowed cities and counties to opt-out of the state’s regulated psilocybin program, and last November, many voted not to participate. In contrast, Colorado’s Natural Medicine Health Act requires uniform implementation of the law, and cities and counties can only set reasonable restrictions on the time, place, and manner in which psilocybin services are offered. SB 5263 follows Colorado’s example, eliminating the ability of cities and counties to opt-out and allowing only reasonable local regulations on psilocybin service centers and manufacturers.
Enhanced Client Data Protections
Maintaining client data privacy and confidentiality has become a controversial issue. Psychedelics remain federally illegal, and the information derived from psychedelic experiences is valuable and sensitive. If client data falls into the wrong hands, it could expose them to social, legal, and professional risks. For instance, clients could be discriminated against when they apply for employment, housing, and other benefits and services. To address this concern, Washington’s SB 5263 charges psilocybin facilitators with “maintaining the confidentiality of client information to the greatest extent possible.” Clients will also have the right to control their data and how it’s used, including whether it is shared with third parties outside a service center.
Expanded Social Opportunity Program
The previous version of SB 5263 included a social opportunity program to encourage participation of people from low-income regions of the state. Program participants will pay reduced license fees as determined by the Department of Health in consultation with Washington’s Psilocybin Advisory Board, which will be appointed by the Governor. Unlike Oregon’s program, where reducing fees for one group necessitates increasing them for others, any budget shortfall created by reducing fees for Washington’s Social Opportunity Program will be subsidized by the state. The refreshed version of Washington’s proposed bill also expands the social opportunity program to include veterans and persons who have a traditional or Indigenous history with psychedelics. The Department of Health has discretion to allow other communities to participate in the program.
Codified Client Bill of Rights
Last year, the Oregon Psilocybin Advisory Board approved a client bill of rights that was largely adopted by the Oregon Health Authority. This bill of rights will be displayed prominently in service center locations and must be reviewed with their clients. SB 5263 codifies this bill of rights, ensuring universal rights for Washington psilocybin clients. Its text reads as follows:
CLIENT BILL OR RIGHTS
Clients receiving psilocybin services in Washington have the following rights:
(1) To be treated with dignity and respect while receiving psilocybin services.
(2) To receive culturally competent care.
(3) To be free from physical, sexual, psychological, and financial abuse before, during, and after receiving psilocybin services.
(4) To be fully informed of, and helped to understand, the risks associated with psilocybin services.
(5) To make decisions autonomously, free of coercion and undue influence.
(6) To be fully informed of the benefits and risks associated with psilocybin services.
(7) To privacy and confidentiality and to control how their information is processed and used.
(8) To decline to participate in research or share information with third parties, except as required by law.
(9) To a full accounting and explanation of all facilitator conflicts of interest and the costs associated with receiving psilocybin services before receiving those services.
(10) To have belongings stored securely while receiving psilocybin services.
(11) To be monitored and supported by a licensed facilitator for the duration of psilocybin services until it is safe for the client to be transported home, transferred to the care of a responsible friend or family member, or released on their own recognizance.
(12) To access services that are welcoming to people with disabilities.
(13) To discuss this Bill of Rights with licensed facilitators and service center operators without facing discrimination or retaliation.
(14) To report violations of this Bill of Rights to the Washington Department of Health, or other appropriate governing body, without facing discrimination or retaliation.
SB 5263 may undergo changes before making its way to the Washington legislature this spring for a vote. Stay tuned to Psychedelic Week for more updates and detailed analysis.
January 5, 2022
On Tuesday, Washington State legislators filed SB 5660, a bill that would legalize the supported adult use of psilocybin by people 21 years of age and older.
Sponsored by Senators Jesse Salomon and Liz Lovelett, the bill, known as the Washington Psilocybin Wellness and Opportunity Act, includes many innovative features including a Social Opportunity Program to help address harms caused by the war on drugs, support for small businesses, and accommodations for people with certain medical conditions to receive the psychedelic substance at home.
I had the privilege of helping to draft the Washington Psilocybin Services Wellness and Opportunity Act with input from the Psychedelic Medicine Alliance of Washington. We had previously collaborated on the psychedelic decriminalization resolution adopted unanimously by the Seattle City Council.
Passage of the SB 5560 would enable the Washington Department of Health to issue licenses to psilocybin manufacturing facilities, testing labs, service centers, and facilitators. It will also create the Washington Psilocybin Advisory Board to advise the Department on creating rules for the Act’s implementation.
Though psilocybin is non-addictive, the bill’s sponsors recognize the benefits of supported adult use. In this model of regulation, trained and licensed professionals called facilitators administer psilocybin under supportive conditions at licensed service centers.
Under supported adult use, psilocybin services are made available to people 21 and older for nearly any purpose – the Act specifies that clients need not have a medical condition to participate, and psilocybin services in Washington will not constitute medical diagnoses or treatment. Psilocybin is known to enhance feelings of connectedness, and some clients may seek psilocybin services to feel connected with nature or see existing relationships in a new light. Others may wish to enhance overall wellness, have a religious experience, or boost creativity.
Though psilocybin can cause mild side effects such as transient nausea, and anxiety, it has an impressive safety record, and Indigenous communities in Mexico, such as the Mazatec, have used it in religious rituals for centuries.
In the 1950s and 60s, medical researchers studied psilocybin’s therapeutic properties, and they made substantial progress, publishing their observations in prestigious medical journals. However, since the 1970s, when Congress passed the Controlled Substances Act and President Nixon launched the war on drugs, psilocybin has been banned. Until recently, the Drug Enforcement Administration prohibited even scientific research on this Schedule I controlled substance. Nevertheless, a scientific and legal renaissance has emerged in the past few years.
What started with a handful of small research studies in the early 90s has grown to include publicly traded companies, the infusion of millions in venture capital, and multiple clinical trials sanctioned by the Food and Drug Administration (FDA). Because psilocybin has the potential to treat depression more effectively than existing therapies, such as selective serotonin reuptake inhibitors (SSRIs) like Prozac and Paxil, the FDA calls it a Breakthrough Therapy.
Alongside medical research and the commercialization of psilocybin, grassroots legal reform movements have formed. Unwilling to idly stand by as rates of suicide and mental illness climb in their communities, activists across the country are creating legal reform. Denver was the first U.S. city to decriminalize psilocybin in 2019 when voters passed Initiative 301, which made psilocybin possession the city’s lowest law enforcement priority.
At least a dozen other cities have since followed suit. Many jurisdictions, like Seattle, which became the largest city to decriminalize in October, added other naturally occurring psychedelics to the list of decriminalized substances. During the 2020 presidential election, Oregon voters passed Measure 109, created a legal psilocybin industry in the state. Governor Kate Brown assembled the Oregon Psilocybin Advisory Board, which includes five subcommittees focused on psilocybin research, health equity, products, licensing, and facilitator training. I chair the Licensing Subcommittee, which drafts rules on licensing requirements for psilocybin businesses and facilitators.
One concern raised by Oregon’s Health Equity Subcommittee is the ability of people with disabilities to access psilocybin if they cannot travel to a licensed service center. During public comment periods, the Oregon Board has heard from people like Eileen Brewer of Cluster Busters, an organization representing the interest of people with cluster headaches. There is evidence that people with severe headaches may benefit from psilocybin services, and Eileen explained that it would be cruel and impractical to require people with severe headaches to travel to a service center. Others may be unable to travel due to strength or mobility issues. To address this concern, Senators Salomon and Lovelett included a provision that will allow people who are medically unable to travel to receive psilocybin services at home.
Similarly, to accommodate working professionals, people with disabilities, and others for whom traveling to in-person courses may be burdensome, Washington will allow facilitators in training to complete the bulk of their training remotely. The training curriculum will also be modular, and trainees will be able to piece together their own customized program by selecting from the courses that best fit their needs. This approach will create a competitive market for training programs that will drive innovation and help keep costs down.
In Washington, SB 5660’s Social Opportunity Program will help address the harmful impact of war on drugs on many marginalized communities. It will offer reduced licensing fees to residents of distressed areas of Washington, including those where the three-year unemployment rate is at least twenty percent higher than the statewide average, and those where at least twenty percent of households participate in the federal supplemental nutrition assistance program (SNAP). Participants will also benefit from technical assistance and receive points that supplement their license application score. In a similar vein, the Act’s Micro Tier license designation, called an endorsement, will help aspiring psilocybin manufacturers access the emerging industry.
Other features include the potential for some psilocybin services to be provided remotely, including preparatory sessions, which help establish rapport between facilitators and clients and prepare clients for psilocybin administration, and optional integration sessions that help clients process their psilocybin experiences after an administration session.
These are only a few innovations included in the Washington Psilocybin Services Wellness and Opportunity Act. Fundamentally, SB 5660 is a novel approach to the supported adult use of psilocybin. It will allow clients to receive safe psilocybin products from licensed professionals and create economic opportunities for people statewide.
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